Imagine spending eight years after high school studying for your dream career. You apply to every medical school you can think of. If you don’t get into a cheaper state school, you apply to more expensive private medical schools. Some aspiring physicians even apply to schools in other countries. When you finally graduate you must then apply for graduate medical education (GME) training programs, which are required before you can practice medicine in all 50 states.
I calculated what my ($4,000) Costa Rican dental work in 2021 would have cost in the United States. My back of the envelope math is about $12,000. Previous trips cost about $2,000 if I recall, including the implant, oral surgery with bone graft, panoramic x-ray, deep cleaning and two crowns. Basically, what would have cost more than $18,000 in Dallas was about $6,000 in Costa Rica. The quality is great and it was one-third the price.
In 2018 the Centers for Medicare and Medicaid Services (CMS) suddenly removed Auryxia (ferric citrate) from the Medicare Part D drug formulary and began to require prior authorization for the few indications it would reimburse. CMS gave little information about the reversal but apparently made the decision because it views ferric citrate at a mineral product, like dietary supplements such as Vitamin C. Dietary supplements are not covered by Medicare except in a few cases.
My dog had to go to the veterinarian on Tuesday for her annual visit. Where I live vets aren’t particularly cheap, but they have one thing us human patients do not: price transparency. Since most pet owners don’t have health insurance for their pets, they are more price sensitive. Because vets don’t have many different insurance companies to bill, prices tend to be uniform. One vet we’ve patronized even has a list of lab test prices on each exam room wall. It explains the cost of various individual tests and a package price if all were performed together. Another vet has a note on the interior door that reads, “Did you make an estimate???” When is the last time you saw a sign like that in your physician’s office? Probably never.